面神经液压与面神经电图的相关性研究

目的　探讨面神经电图作为面神经减压手术指征的病理生理学基础。方法　利用电生理仪和伺服微变量微压系统 ,对正常和压榨伤后面瘫不同时期的豚鼠 ,作面神经电图检查 ,再采用微创测压法进行面神经液压的测量 ,得出面神经损伤后不同时期的面神经动作电位降幅及相应的面神经液压 ,并观察不同时期面神经光镜和电镜下的组织学改变。结果　面神经损伤 3d至 3周 ,随着面神经液压的升高 ,面神经动作电位降幅百分数亦增加 ,二者间有明显相关性 ,损伤后 2周和 3周 ,面神经液压和面神经动作电位降幅的相关系数分别为 0 88和 0 51。神经液压的变化与面神经Wallerian变性各期组织学改变相一致。结论　在面瘫 3周内 ,面神经电图的改变可间接反映面神经液压的变化 ,并可为面神经减压术的时机提供客观、可靠的实验依据。

Research of relationship between endoneurial fluid pressure and electroneurography of the facial nerve

Objective The relationship between endoneurial fluid pressure (EFP) and electroneurography (ENoG) of the facial nerve was studied in order to evaluate the ENoG as the basis of pathophysiology of the decompression of the facial nerve Methods The values of ENoG were recorded by an instrument of physiology on the normal and crushed facial nerves of guinea pigs Endoneurial fluid pressures were measured by a servo-nulling micropipette system at the same time After the EFP were measured, the facial nerves were removed and fixed properly for examination under the light and electron microscope in order to determine the differences from various periods after injury Results EFP in the facial nerve was changed significantly during the period of three days to three weeks later after crushed injury, and the percentage of degenerated facial nerve fibre was the same There was positive correlation between ENoG and EFP After crushed injury 2 and 3 weeks, the coefficient was 0 88 and 0 51, respectively It could be found that extensive edema in endoneurial and perivascular spaces of the facial nerve occurred in early stage of injury, but numerous Schwann cells proliferation appeared in the later period Conclusion The change of ENoG could reflect the value of EFP relatively within three weeks after crushed injury It was suggested that ENoG could be useful in evaluating the pathogenesis underlying facial palsy And it could be provided a basis indication for decompression of the facial nerve